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2. First name*
3. Last name*
4. Phone number*
6. Address*
7. Email
9. How long have you been a member of the Hopkins community?*
10. What is your occupation? *
11. Do you rent or own your home?*

    1. Homeowner
    2. Renter
13. The Partners in Energy process asks that community members commit approximately 15 - 20 hours over 6 months to attending workshops and contributing feedback to our energy action plan. Five in-person workshops are planned to be held on May 18, June 29, August 10, September 21, and October 26. Each workshop is expected to be about 2 - 2.5 hours long. Are you able to commit this time to the workshops?*

    1. Yes - I can attend most or all workshops
    2. No - I cannot attend most workshops
    3. Unsure
15. Please let us know what your concerns are with the time commitment.
17. What organizations or groups do you have connections to? Please select all that apply.

    1. City government or commission
    2. Community-service organization (e.g. food shelf)
    3. Homeowners association
    4. Higher-education institution
    5. K-12 school district
    6. Local business
    7. Local congregations or faith-based organizations
    8. Local civic or professional organizations (e.g. rotary club)
    9. Other
19. If other, please describe.
21. We want to represent all areas of our community with a diverse group of community members. Please describe what unique perspectives you will bring to the table. *
23. Please describe any education, professional or volunteer experience related to energy, including electricity, natural gas, building trades, or renewable energy.*
25. Please describe your qualifications, interests and experiences that would support developing an energy action plan. *
27. Have you ever served on a City or County board or commission?*

    1. No
    2. Yes
28. If yes, where and how long?
30. Please briefly describe your interest in contributing to our Energy Action Plan. *
32. What do you hope to accomplish by participating?*
34. After our Energy Action Plan is complete, we will spend the next 18+ months implementing the plan. Implementation support may include tabling at events, hosting or supporting workshops, or otherwise acting as a liaison to share messages and promote action. How do you see yourself supporting implementation?*
36. Have you participated in a project like this before? If yes, what was your experience like?*
38. Is there any other information you feel we need to know?
40. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
42. Electronic Signature
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44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

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